加减归脾汤治疗甲基丙二酸尿症认知障碍心脾两虚患儿的临床疗效观察  

Clinical efficacy observation on the modified Guipi Decoction in treating children with cognitive impairment of methylmalonic aciduria of heart and spleendeficiencysyndrome

作　　者：陆相朋 彭琰琰 郑宏[3] 党伟利[3] 张弛[3] 冯斌[3] 冯刚[3] 马丙祥 LU Xiangpeng;PENG Yanyan;ZHENG Hong;DANG Weili;ZHANG Chi;FENG Bin;FENG Gang;MA Bingxiang(Hebei University of Chinese Medicine,Shijiazhuang 050091,China;Zhengzhou Central Hospital,Zhengzhou 450007,China;The First Affliated Hospital of Henan University of CM,Zhengzhou 450000,China)

机构地区：[1]河北中医药大学,石家庄050091 [2]郑州市中心医院,郑州450007 [3]河南中医药大学第一附属医院,郑州450000

出　　处：《中华中医药杂志》2024年第8期4478-4482,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金面上项目(No.82274579);国家自然科学基金青年科学基金项目(No.82104929);国家中医临床研究基地科研专项(No.2019JDZX2056);河南省科技厅科技攻关项目(No.212102310364)。

摘　　要：目的:观察加减归脾汤治疗甲基丙二酸尿症(MMA)心脾两虚证认知障碍患儿的临床疗效。方法:采用随机、双盲、安慰剂对照的观察试验设计,将65例MMA心脾两虚证认知障碍患儿随机分为试验组(32例)和对照组(33例)。两组患儿均给予西医基础治疗及认知功能训练,在此基础上试验组给予加减归脾汤颗粒治疗,对照组给予模拟剂颗粒治疗,疗程共12周。在治疗前后采用Griffiths神经认知发育量表(GDS-C)及婴儿-初中生社会生活能力量表(S-M)对患儿认知功能进行评估比较。结果:治疗后两组患儿GDS-C量表总发育商及S-M量表标准分评分均有提升,其中试验组患儿GDS-C量表各分领域包括个人社会、听力与言语、手眼协调、操作表现评分及总发育商高于对照组(P<0.05,P<0.01);试验组S-M量表评分在独立生活、作业操作、交往、集体管理、自我管理评分及标准分高于对照组(P<0.05,P<0.01)。治疗前后未发现明显不良反应。结论:加减归脾汤可有效地改善MMA心脾两虚证患儿的认知功能,提高患儿生活质量。Objective:To observe the clinical effect of modified Guipi Decoction on cognitive impairment children with methylmalonic aciduria(MMA)of heart and spleen deficiency syndrome.Methods:Randomized,double blind,placebo controlled method was used in this study.Sixty-five children with cognitive impairment of MMA with heart and spleen deficiency syndrome were randomly divided into the test group(32 cases)and the control group(33 cases).Children in both groups were given basic treatment of western medicine and cognitive function training.On this basis,the test group was given modified Guipi Decoction Granules,and the control group was given simulated agent granules.The course of treatment was 12 weeks.Before and after treatment,Griffiths Neurocognitive Development Scale-Chinese Language Edition(GDS-C)and Infant-Junior High School Students Social Life Ability Scale(S-M)were used to assess and compare the cognitive function of children.Results:After treatment,the total developmental quotient of the GDS-C scale and the standard score of the S-M scale of the children in the two groups were improved,and the scores of the GDS-C scale of the children in the test group,including individual society,hearing and speech,hand-eye coordination and operation performance,were higher than those in the control group(P<0.05);The score of S-M scale in the test group was significantly higher than that in the control group in terms of independent life,homework operation,communication,collective management and self-management(P<0.05).No adverse reactions were found before and after treatment.Conclusion:Modified Guipi Decoction can effectively improve the cognitive function of MMA children with heart and spleen deficiency syndrome and improve their quality of life.

关 键 词：甲基丙二酸尿症 儿童 认知障碍 归脾汤 临床研究 

分 类 号：R749.1[医药卫生—神经病学与精神病学] R725.8[医药卫生—临床医学]